As a student at the University of Washington School of Medicine, Dr Ward did a student rotation at, what was then, Stevens Hospital. That experience established a foundation for understanding the value of community based medicine, and his career has been focused on advancing state-of-the-art cancer care in a compassionate and accessible setting. It drives the personal care he gives his patients and a dedication to his profession.

It is this focus that has led him through 19 years of service as Medical Director of Providence Hospice of Snohomish County and an eight year term as Chairman of the Stevens Hospital (now Swedish Edmonds) Cancer Control Committee, firmly believing that great oncology care requires a team approach across a continuum of care settings. In addition, Dr. Ward has a natural talent for making complicated oncology topics easy to understand, and takes them from the bedside to a local newspaper column.

It's in his daily interactions with patients that Dr. Ward maintains his zeal and focus. In his first newspaper column a decade ago, Dr Ward, while acknowledging the excitement and intrigue in the science of cancer, wrote;

"...it is the patients themselves who teach me the most important lessons. My patients remind me day after day that there is more than one way to beat cancer. The human spirit is more resilient than the human body and the ability of individuals to rise above the adversity of the moment never fails to impress me that it is not how long we live, but how we live that determines our legacy."

As a student at the University of Washington School of Medicine, Dr Ward did a student rotation at, what was then, Stevens Hospital. That experience established a foundation for understanding the value of community based medicine, and his career has been focused on advancing state-of-the-art cancer care in a compassionate and accessible setting. It drives the personal care he gives his patients and a dedication to his profession.

It is this focus that has led him through 19 years of service as Medical Director of Providence Hospice of Snohomish County and an eight year term as Chairman of the Stevens Hospital (now Swedish Edmonds) Cancer Control Committee, firmly believing that great oncology care requires a team approach across a continuum of care settings. In addition, Dr. Ward has a natural talent for making complicated oncology topics easy to understand, and takes them from the bedside to a local newspaper column.

It's in his daily interactions with patients that Dr. Ward maintains his zeal and focus. In his first newspaper column a decade ago, Dr Ward, while acknowledging the excitement and intrigue in the science of cancer, wrote;

"...it is the patients themselves who teach me the most important lessons. My patients remind me day after day that there is more than one way to beat cancer. The human spirit is more resilient than the human body and the ability of individuals to rise above the adversity of the moment never fails to impress me that it is not how long we live, but how we live that determines our legacy."

Not long ago, I read two articles, one by a cancer doctor and another by a journalist. They both left me steaming a bit. In medicine, we talk about the science (the factual database and knowledge that we use) and the art of medicine (how we use and adapt that database to the benefit of individual and different patients). Both of these articles, the first overtly and the second more indirectly, suggested that the art of medicine is about hiding the science from the patient in order to provide hope, albeit false hope to the cancer victim. Let me state clearly, despite paternalistic instincts, dishonesty has no place in the practice of oncology.

Both of my grandmothers died from cancer. Grandma S. died of stomach cancer when I was in college. As far as I know, she was never told that her cancer had recurred after surgery. Her second husband and family wanted it that way. “Knowing that she has cancer will devastate her, let her have her hope,” we were told. When my cousins and I visited, we were under strict orders to not ask too many questions about her “gall stone” problems. She knew though. You could see it in Grandma’s eyes. But the web that had been woven kept her from being able to grieve and gave no opportunity for good byes. As she slipped away she became withdrawn and depressed.

Grandma B. was diagnosed with an aggressive lymphoma when I was just out of medical school and in my training. She was fully informed by her doctors. She had opportunity to seek second opinions. She conferenced with her children. When she chose to not leave her little ranch valley in Idaho for desperate treatments far from home, and to die in her own home, her family rallied around her in support. For six weeks, she narrated her life history, wrapping up a legacy of lasting value for her family. She was the recipient of an outpouring of love from her community and she died fulfilled, with a smile of satisfaction on her face.

Some of the most popular misconceptions surrounding cancer, cancer prevention and cancer treatment are about the role of antioxidants. Like many of the popular myths about cancer, there are facts, half-facts and outright falsehoods.

Fact: Damage to genes, particularly those involved in the regulation of cell division and cell death, is the key event in the development of cancer. Fact: Oxidants are substances, most often generated by our own body, that cause damage to chemicals, including the DNA that makes up our genes, by oxidizing them. The oxidation reaction most familiar to us is when metal rusts. Fact: Our bodies’ oxidants can contribute to cancer.

Half-fact: Antioxidants are chemicals we ingest that then run around neutralizing oxidants, rendering them powerless to promote cancer. The so-called antioxidant vitamins, of which vitamin C, E, and beta-carotene are the most well known are more properly called redox agents. In a particular environment, they prevent or reverse oxidation, called reduction. But they may change the acidity or even just the concentrations of the components of the reaction, and they may facilitate just the opposite. For example ....

The question caught me off guard for a moment, then its meaning sunk in. She was really saying, “Cancer is serious stuff, my breast has been cut on and radiated, and you’ve given me cancer fighting poisons in my veins. My hair has fallen out, food tastes funny, and I’m on a first name basis with the muzak at my insurance company. I’ve done my crying, but is it appropriate to laugh at it all?”

I remembered back to an intimidating nurse critiquing a tape of my very first patient interview during my second month of medical school. Her eyes were sharp and piercing and her brow furrowed as she watched the tape. Half way through she stopped it, turned it off, and said, “You are flippant…. I don’t much care for it.” My heart sank, and then she continued without a smile, but with a twinkle in her eyes, “but it works for you, so don’t mind me and keep on doing it.”

I believe that humor is therapeutic. Of course, that is not a new idea. The saying, “laughter is the best medicine” did not originate with Readers Digest. The biblical record states, “A merry heart does good like medicine, but a broken spirit drieth bones” (Proverbs 17:22). I don’t know that a merry heart will add time to a cancer patient’s life, but I know that it will add life to the time that they have.

We don’t know a lot about the physiological effects of humor. It does ....

I was traveling last week. After the stewardess pointed out the exits, the broad shouldered gentleman stuffed into the seat next to the seat I was stuffed into, decided to make some small talk. “What kind of work do you do?”

“I am an oncologist,” I said, and prepared myself for what I knew was coming next. There are only two responses to “I am an oncologist.” The first is, “what’s that?” (The word oncology is code. In the 60s it was politically incorrect to say “cancer”. Even today, patients and clinicians stumble around the word, preferring terms like malignancy, neoplasm, tumor, or just lump. Cancer care was entering the dawn of an era where not everyone was going to die and was soon to become a new specialty, so the word “oncology” was coined to avoid saying the “C word.” But when someone doesn’t know the code word you have to be direct. “I am a cancer doctor.”)

If the second question isn’t asked first, it is asked next. It isn’t really said like a question, it’s more like a statement with a question mark. Sometimes the statement is one of wonderment, but as often as not it is pity. “Why did you decide to be a cancer doctor?”

Cancer is a fascinating disease. It is the closest thing, in this life, that we will get to immortality. Take cancer cells, put them in a test tube and take care of them right and those cells can be grown forever. Take our normal cells and care for them the same way and they will be dead in two weeks. We do research on cells harvested from cancer patients 20 years ago. Besides being mortal our normal cells respect the space of other cells ...

A cancer doctor is very familiar with the anxious and fearful grief that accompanies a diagnosis of cancer. We are less acquainted with the lonely and empty grief that is experienced by those left behind when our patients die. However, when I wear my hospice medical director hat, I am privy to those struggles, and knowing that the loss of someone close is particularly difficult during the holidays, I have chosen to divert from subjects I am more familiar with and rely on the experts at hospice to help me present a meaningful discourse on grief during the holiday season.

For the bereaved, the joyous holidays trigger emotions of great conflict. Every act of preparing for the holidays, once a time of cheer and anticipation, becomes another stabbing reminder of ones loss. The demands of family and friends, always a bit stressful around Thanksgiving, Hanukkah, Christmas, and New Year, now are overwhelming, both physically and emotionally. Traditions, designed to create love and family unity, now seem empty and may even create divisions among the grieving. Even successful celebration may bring on a deep surge of guilt for enjoying the holiday alone. And those who have no physical or emotional reserves left for thanksgiving or joy making, may feel great pressure to “get on with their life, and join in the fun.”

It has been suggested that the key word in grief is “permission.” The bereaved need permission from themselves, and from family and friends, to grieve as long as necessary and in any way that works, remembering that what works may not always be the same. It means permission to only do what you can. A turkey and all the trimmings may just be too much this year. Eating out may be perfect. Having someone else do dinner may be better yet.

Permission may also be needed to change some timeworn traditions. It must be recognized that ...